I am 12 years old, I have had diabetes for almost a year, and right now I have a high blood sugar at almost every meal. We have adjusted all of insulin but it hasn’t helped. On weekends, I always have episodes of low blood sugar. Can you please help decide what to do?

Wow — how frustrating — and good for you that you are thinking about how to fix it! there are several things to think about:

First, how close to target is your overall control? What is your current hemoglobin A1c? If your A1c is okay, but your meter values are high — try checking at “odd” times, like two hours after a meal or in the middle of the night. You might be having low sugars throughout the day without knowing it. If your A1c is high like your blood sugars, then you are probably having high sugars most of the time and may need more insulin.

That brings us to the second idea: If you need more insulin, which one should it be? It is not unusual at your age to need quite a bit of insulin because of the hormone changes your body is experiencing during puberty. When they add up all their insulin in a day, some kids need as much as one-half to one 1 unit of insulin for every pound they weigh.

The third thing I would look at is: what is different about the weekend versus the weekdays? Are your sugars higher during the week because of school stress? Are they lower over the weekend because of more activity? Are you eating differently from weekday to weekend? You might need insulin doses that are different during the week than from the weekend. Maybe your parents or your diabetes team can help you figure this out.

Lots to think about, right? Best of luck and keep on learning how diabetes works in your situation!

BS